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Is Conversion Disorder a non-falsifiable theory?

T

Turnitoffandonagain

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I have a list of debilitating and painful symptoms that have come on progressively over more than 30 years. Between them I would say they have ruined my life, as each form of purpose and pleasure I could get from life has been progressively wrecked by them. Career, any hope of a love-life, and now even physical fitness have all been largely ruined. I am now in pretty much constant pain and discomfort of at least four distinct forms (and the 'discomfort' is worse than the pain).

None have ever gotten a diagnosis by medics.

Generally I end up being referred to psychiatrists and therapists on the grounds that the symptoms are either 'somatization', 'psychosomatic' or 'due to anxiety'. I have so far had zero success with any psychiatric treatment for these symptoms, including pretty much ever variety of SSRI (and an SNRI and some tricyclics plus metazapine) that there is, and CBT and other therapy. (Amitryptyline had _some_ effect on some of the pain and on the bad sleep caused by the symptoms, but not so great as, to my mind, to be worth the possible long-term side-effects)

I believe this is because the symptoms are not actually psychological in the first place, but physical. Just because medics can't find something does not mean it isn't there, not unless you add an extra assumption that medics are omniscient.

But it seems as if the concept of conversion disorder is not falsifiable, and hence, surely, not scientifically valid. If the treatment doesn't improve the symptoms, then the verdict is invariably that it's because the patient didn't believe in the treatment sufficiently. In that respect it seems very much like a form of faith healing. I have even had psychiatrists telling me to believe in SSRIs more than I do because my disbelief reduces their effectiveness (my disbelief being based on having tried so many of them and found them useless or worse - the first one I tried I expected great things from, but it still didn't deliver). How is this any different from mystics and faith-healers?

Essentially they tell you to get better, or to ignore the symptoms or behave as if the symptoms weren't there. If you manage to do so, then the treatment is considered a success (despite the fact that the pain is still there, as you can act as if it isn't then you are 'better'). If you are unable to do so (because the symptoms are just so unpleasant and debilitating that you can't ignore them or pretend they aren't there) then it's your fault for not following the treatment.

There seems to be no way the treatment, or the diagnosis of somatization disorder can ever be shown to be wrong. Any failure is always the patient's fault. Which surely means it's not a valid scientific concept?

Edit - one symptom did actually go away on its own accord for a period of 3-4 years, only to suddenly return, followed by another new problem. There seemed to be no correlation with any psychological issues for this.


How is it anything other than a dustbin diagnosis to apply to any symptom the medical profession are unable to otherwise diagnose?
 
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T

Turnitoffandonagain

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To expand, because these symptoms are continuing to ruin my life and torture me with complete sleep deprivation among everything else (its like being followed around by an invisible torturer, or having someone stick pins in a voodoo doll of you), I think the reason this diagnosis even exists is because neither medicine nor psychology/psychiatry is a scientific practice.

Neither is about rationally investigating reality via the scientific method. What they are, is'professions' - sociological phenomena, a kind of priesthood whose first and most important priority is serving the interests of the 'priests'. _Not_ establishing truth by objectively looking at reality, still less meeting the needs of the patient.

They don't _think_ about problems, they follow flowcharts and checklists that embody the tiny bit of real knowledge they have (but which they imagine represents 90% of reality rather than 10% of it).

Now if those flowcharts happen to identify the problem then it's win-win - both the patient and the medic/psychiatrist get what they want. But if, as is overwhelmingly likely to be the case given the highly limited nature of those flowcharts compared to the reality of the human organism, it doesn't identify the problem, it just gets explained away 'God of the gaps' style, as 'conversion disorder' (or 'anxiety' or 'somatization')


All the tests I've had, for example, were obviously not going to find the cause of the problem because medical tests are largely about taking momentary snapshots of one small part of the system, that are unlikely to catch the actual problem. They don't look at what the symptoms suggests needs to be looked at, they look at what they know how to look at.

They are based not on thinking about what needs to be examined given the nature of the symptoms the patient is experiencing (as you would if you were trying to analyse a problem scientifically), they are about 'what few things do we know how to look at?'. They are exactly the phenomenon of the drunk guy looking for his keys on the opposite side of the street to where he dropped them 'because the streetlights are brighter there'.

Then when the tests, predictably, don't find anything, they declare 'it must be psychological'. This is not scientific, this is a cop-out. It is exactly how it would be if physics included the concept of 'the demons did it' as an all-purpose way to explain away anything that isn't explained by current theories.

People complain (not incorrectly) about 'alternative medicine' not being scientifically-based, but what that complaint conceals is that the same is true of conventional-medicine, which has only a very distant relationship to science or rationality. The existence of this diagnosis is evidence of that.

If you happen to have a debilitating, life-wrecking, condition which doesn't fall into the small minority of things medics actually know about (that their flowcharts actually pick up) you are pretty much done for.

(Now they are pushing psychiatric drugs at me again, anti-psychotics this time, with all the horrible side-effects those have, and still just on the vague, hand-waving 'we haven't anything else to offer' basis and despite still not having one any _proper_ test that would be relevant to the symptoms. Forget that, no way).
 
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T

Turnitoffandonagain

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Well, having rejected antipsychotics (because I have seen in people I know the horrible effects of those drugs, and because I don't believe they are in any way relevant to my problem, which isn't likely to be solved by randomly scrambling up my brain chemistry) I've been discharged. So that was a 2 year process of being referred from one agency or service or hospital to another (I think I was assessed by seven different services/professionals in the course of that before ending up back where I started).

I increasingly am of the belief that the very existence of this diagnosis is a sign of how medical science is not really all that scientific. Conversion disorder is surely just hysteria by a new name, which in turn is really just a descendant of 'demonic possession'. When they say your physical symptom is 'psychosomatic' what they mean is 'its the invisible demons doing it'. It's what they say to explain away anything they don't have another answer for, because medics don't like to admit how little they really know. It's surely what is called 'the God of the gaps' in other contexts.

Seems to me that once you allow such occult spirits into your taxonomy as causative agents you have given up on claims to basing a discipline on reason and evidence. In short, I think it's nonsense.

Meanwhile my health continues to deteriorate and the pain and incapacity keeps slowly increasing, as it has been doing, in sudden steps, for decades now.

Thanks for nothing, medical profession.
 
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